Abstract
In the current report a case of a 26-year-old male with a primary dedifferentiated liposarcoma of the femur accompanied by malignant fibrous histiocytoma is presented. The patient complained of a dull intermittent pain, for three months, along the anterolateral aspect of the right knee and was referred to Southwest Hospital (Chongqing, China) in May 2013. All of the radiographic findings, including radiography, magnetic resonance image and emission computed tomography (CT) supported the diagnosis of a primary malignant bone tumor. CT-guided biopsy results demonstrated blood clots and a small quantity of heterogeneous cells. Thus, a limb-salvage procedure, involving a wide resection and total knee endoprosthesis replacement, was performed in May 2012. The final pathological diagnosis was of a primary dedifferentiated liposarcoma of the femur and the dedifferentiated tissue was identified as malignant fibrous histiocytoma. On review of the literature, it was identified that primary intraosseous liposarcoma are a rare and malignant tumor of the skeletal system, with only a small number of cases reported in the English literature since 1980. To the best of our knowledge, a case of dedifferentiated liposarcoma has not previously been reported.
Highlights
Primary intraosseous liposarcoma is a rare and malignant type of skeletal system tumor; the first case was reported in 1931 by Stewart [1]
Since 1980, only a small number of cases of primary liposarcoma involving a long bone have been described in the English literature
The final pathological diagnosis was a primary dedifferentiated liposarcoma of the femur, and the dedifferentiated tissue was identified as malignant fibrous histiocytoma
Summary
Primary intraosseous liposarcoma is a rare and malignant type of skeletal system tumor; the first case was reported in 1931 by Stewart [1]. There was no history of accident, injury, fever, weakness or weight-loss The patient visited another hospital in April 2012 and radiographs demonstrated a tumorous lesion in the right distal femur. The radiographs revealed an expansile and osteolytic lesion of the right distal femur with a periosteal reaction (Fig. 1). Magnetic resonance imaging demonstrated an expansile, intramedullary, poorly defined neoplasm with a moderately high signal intensity area on T1- and T2-weighted images in the distal part of the femur, with diffuse erosion of the cortex and involvement of the surrounding soft tissue (Fig. 2). A combination of numerous giant tumor cells and fatty tissue with different degrees of differentiation was observed (Fig. 6). The final pathological diagnosis was a primary dedifferentiated liposarcoma of the femur, and the dedifferentiated tissue was identified as malignant fibrous histiocytoma. Radiography indicated that the artificial joint was in good condition
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